CAJ | 학술논문

目的：探讨妊娠期母体甲状腺自身免疫与亚临床甲减对子代智力与运动发育的影响。方法选择自身免疫性甲状腺疾病产妇共141例，分成四组，分别为亚临床甲减﹢甲状腺过氧化物酶抗体（ TPOAb）（﹢）组，共29例；亚临床甲减﹢TPOAb（-）组，共36例；单纯TPOAb（﹢）组，共40例；非亚临床甲减﹢TPOAb（-）对照组，共36例。采用贝利婴幼儿发展量表随访24~30月龄子代的智力与运动评分。结果亚临床甲减﹢TPOAb（﹢）组智力与运动评分均低于其余各组，其中智力显著低于亚临床甲减﹢TPOAb（-）和对照组，运动评分显著低于对照组（ P均﹤0.05）。而亚临床甲减﹢TPOAb（﹢）组与单纯TPOAb（﹢）组在智力和运动评分比较中无统计学差异（ P均﹥0.05）。结论亚临床甲减伴有TPOAb阳性可能对子代神经系统发育造成影响，因此需及时治疗。妊娠期单纯TPOAb阳性也可能会影响子代神经智力与运动发育造成一定影响，因此建议对妊娠早期母体TPOAb进行广泛筛查，如出现促甲状腺激素增高，也应及时治疗。
목적：탐토임신기모체갑상선자신면역여아림상갑감대자대지력여운동발육적영향。방법선택자신면역성갑상선질병산부공141례，분성사조，분별위아림상갑감﹢갑상선과양화물매항체（ TPOAb）（﹢）조，공29례；아림상갑감﹢TPOAb（-）조，공36례；단순TPOAb（﹢）조，공40례；비아림상갑감﹢TPOAb（-）대조조，공36례。채용패리영유인발전량표수방24~30월령자대적지력여운동평분。결과아림상갑감﹢TPOAb（﹢）조지력여운동평분균저우기여각조，기중지력현저저우아림상갑감﹢TPOAb（-）화대조조，운동평분현저저우대조조（ P균﹤0.05）。이아림상갑감﹢TPOAb（﹢）조여단순TPOAb（﹢）조재지력화운동평분비교중무통계학차이（ P균﹥0.05）。결론아림상갑감반유TPOAb양성가능대자대신경계통발육조성영향，인차수급시치료。임신기단순TPOAb양성야가능회영향자대신경지력여운동발육조성일정영향，인차건의대임신조기모체TPOAb진행엄범사사，여출현촉갑상선격소증고，야응급시치료。
Objective To investigate impact of mental and sports development in offspring by gestational maternal thyroid autoimmunity and subclinical hypothyroidism. Methods A total of 141 cases of maternal autoimmune thyroid disease was selected and divided into four groups, namely a total of 29 cases of sub-clinical hypothyroidism ﹢ TPOAb( ﹢)group. A total of 36 cases was the subclinical hypothyroidism ﹢ TPO-Ab( -)group. Simple TPOAb( ﹢)group had a total of 40 cases and 36 cases in the control group. 24~30 months offspring were follow-up of intellectual and sports score via the Bayley Scales of Infant Development. Results Intellectual and sports scores were lower in subclinical hypot-hyroidism ﹢ TPOAb( ﹢)group than the rest of the group. The intellectual scores of which were significantly lower than the subclinical hypothy-roidism ﹢ TPOAb( -)and the control group. And sports scores were significantly lower than the control group( P ﹤0. 05). And subclinical hypothyroidism ﹢ TPOAb( ﹢)group was no significant different with simply TPOAb( ﹢)group in the intellectual and sports score( P ﹥0. 05). Conclusion Subclinical hypothyroidism with TPOAb positive may impact nervous system development in offspring,so they need timely treatment. Simply TPOAb positive in pregnancy may affect the mental development of the offspring,so we recommend widespread screening TPOAb at early pregnancy. As maternal TSH was elevated,they should be treated.